Thursday, September 17, 2009


The other day I was chatting to a lady whose leg I was about to amputate*. I explained how I was first going to give her an injection in her back, after which she would feel a warm, heavy feeling in her legs before they went to sleep**. Then, I explained, I was going to make a semi-circular cut just above her knee and remove the leg, and that she would perhaps feel some movement and maybe hear some disconcerting sounds (the hacksaw is never pleasant to listen to), but that she would feel no pain and would probably have her first good sleep in months. Afterwards she'd go back to the ward and have lunch and as soon as her pain was improved the physiotherapist would start working with her, and everything would be just fine.

She nodded calmly and seemed to listen carefully through all of this, and then at the end said, 'Yes sister, that's nice, but when is the doctor coming?'

Now, I know. I shouldn't let this kind of questioning bother me anymore, but sometimes it is a bit irritating. Yes, I am short, and I look five years younger than what I am (in a bad way), and all the other doctors here are big strong Afrikaans men (except for the one big, strong Zulu). Maybe it is a bit confusing for some of our more elderly, rural patients who last saw a doctor en route from their mothers' vaginas, and didn't know that girl-children are now allowed to go to university and obtain degrees. Perhaps some people need a loud, tall man to make them feel safe, and a soft-spoken, gentle girl to change their bedpans.

I don't dislike being called Sister because I think I'm better than the nursing staff, or deserve more respect. I can tell that for many of the patients the word slips accidentally out of their mouths, just as many of the more down-trodden non-white farm workers reflexively call me 'Mevrou', (which is somehow worse), but that they still appreciate my expertise (if you can call it that, at my level), regardless of my gender. What really bugs me, is the way some patients assume my knowledge and skills are inferior to those of my male colleagues. It's massively sexist and hugely ignorant. I hate it when I spend quite a lot of time and effort on a patient, and go to great lengths to try to help them and inform them and empower them, and then they frown and tell me they'd like to see the doctor. I get really angry when a patient is seen by a male student (who asks me for advice, and who I help with procedures), and then comes back ten minutes later asking me 'where the doctor is so I can get a sick note'. I loathe the way patients will finish a consultation with one of my colleagues, turn around and walk the few steps to me (usually busy with another patient) and ask me to call the farm to send someone to fetch them. Aaaargh!

I know that the healthiest way of dealing with my irritation is just to laugh it off. I remember one Sunday morning, in my first year of internship at The Swamp, presenting the night's stabbees to my registrar. There, they were in the habit of calling me nursie. 'Nursie!' they wailed, 'I need to pee!' 'Nursie, it hurts, man!' 'Nursie, can you phone my mother?' I was so used to it, I didn't even hear it any more.
'Don't you just love being called Nursie?' laughed my reg. I must've looked a bit downcast, because then he said, 'Don't worry, in a year or two you'll be slicing these bastards open and nobody's going to be calling you nursie then.'

And he's right.

*Yes, another one to cross off my list.
**In true Saffa style, we do the whole operation on our own here.



thank you for writing .. spent many christmases in Umtata, now in Wisconsin, hamba gashle

This drives me absolutely bananas too. It also sure seems like little old ladies are much worse than the men about not accepting women in the doctor's role. I know that this is rude, but lately I totally ignore requests like 'be a nice sister and bring me my x/empty the pee pee bag/fetch me a bed pan/I am finished, you can take the bed pan away now', which are typically made while I am in the room with another patient clearly acting in a doctor's capacity, wearing a long white coat over OR-green with a huge name tag that clearly says 'doctor' on it, a stethoscope hanging out of my pocket and a beeper going off--I often just curtly say 'the nurse will do that, push the button'. It doesn't make me friends, but it does preserve my sanity. The funny thing is that if they didn't start the sentence with 'be a nice sister and...' I would be much more inclined to do these tasks, given that I actually have enough time. Something about the word 'sister' in this context turns on a surge of angriness hormone in my brain and I become immediately unreasonable. I keep waiting for this effect to wear off so that it doesn't make me angry, but so far it hasn't happened.

@ anne, it's not rude. Patients will eventually learn that we are doctors, too.

Be an uppity, snooty bitch if you have to. But always remember an experienced nurse is worth 10 new grad doctors and has lots to teach you, so never, ever be bitchy toward them.

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While I apperciate you giving my photo credit, I still did not give you permission to use it on your blog. Please remove my Blythe nurse photo. Thanks